Maryland § 15-822.1

§ 15-822.1.

    (a)    (1)    This section applies to:

            (i)    insurers and nonprofit health service plans that provide coverage for prescription drugs and devices to individuals or groups under health insurance policies or contracts that are delivered in the State; and

            (ii)    health maintenance organizations that provide coverage for prescription drugs and devices to individuals or groups under contracts that are issued or delivered in the State.

        (2)    An insurer, a nonprofit health service plan, or a health maintenance organization that provides coverage for prescription drugs and devices through a pharmacy benefits manager is subject to the requirements of this section.

    (b)    An entity subject to this section shall limit the amount a covered individual is required to pay in copayments or coinsurance for a covered prescription insulin drug to not more than $30 for a 30–day supply, regardless of the amount or type of insulin needed to fill the covered individual’s prescription.

    (c)    An entity subject to this section may set the amount a covered individual is required to pay to an amount that is less than the payment amount limit under subsection (b) of this section.

    (d)    A contract between an entity subject to this section, or a pharmacy benefits manager through which the entity provides coverage for prescription drugs and devices, and a pharmacy or the pharmacy’s contracting agent, may not:

        (1)    authorize a party to the contract to charge a covered individual an amount that is more than the payment amount limit under subsection (b) of this section;

        (2)    require a pharmacy to collect from a covered individual an amount that is more than the payment amount limit under subsection (b) of this section; or

        (3)    require a covered individual to pay an amount that is more than the payment amount limit under subsection (b) of this section.